Employee Benefits Services Addendum
I. Employee Benefits Services.
Employee Benefits Services. The employee benefits services detailed below will be performed by Namely or an affiliate of Namely appropriately licensed as an insurance producer, broker or agent in the corresponding states for any insurance policy or policies for which Client has awarded Namely or one of its affiliates with Broker of Record (“BOR”) designation (“Employee Benefits Services”).
A. Annual Benefit Renewal and Evaluation
- Assist in the review and renewal of benefit plan designs, benefit levels, insurance premiums, program communications and quality of current employee health and welfare insurance policies for which Client has awarded BOR.
- Provide preliminary estimates of anticipated renewal rates, when possible, to assist Client in preparation of annual benefits budget.
- Conduct market research and thorough market analysis for the purpose of making recommendations on benefit vendor selection and services provided.
- Assist in the review and development of employee health and wellness programs, as needed.
- Represent Client in all negotiations with benefit providers.
- Review prospective rate proposals to ensure underlying assumptions are appropriate and accurate, and are consistent with requested assumptions.
- Provide communication materials regarding the health benefit plans and support for the annual open enrollment period, new benefit offerings and/or changes to the existing health benefit plan offerings.
- Attend and assist with an annual open enrollment meeting, if requested.
B. Analysis and Reporting
- Review Client utilization, experience trends, changing patterns, and plan-specific data for the purpose of guiding benefit plan strategy.
- Provide Client with financial modeling and experience reporting as needed when available.
- Provide Client with summary of all vendor proposals obtained on Client’s behalf, detailing proposal differences, assumptions, and cost calculations.
- Provide benchmark analysis of health and welfare plan offerings and costs to determine competitiveness of Client benefit plans.
C. Client Advocacy
- Act as liaison between Client and health and welfare plan providers, and advocate on Client’s behalf in any conversations with health and welfare plan providers.
- Provide timely customer service and assistance to Client with issues involving but not limited to provider billing issues, claims issues, interpretation of contract language, and general troubleshooting and problem resolution relating to benefit program operations.
- Attend meetings with Client as requested and assist in the management and administration of Client’s employee health and welfare plans.
- Help with the evaluation of Client programs to assist with compliance with state and federal laws, rules and regulations, including ERISA, HIPAA, and PPACA, and provide information about applicable new or proposed laws, rules and regulations.
- Provide Client with education regarding regulatory updates and/or best practices for the effective administration of health plans.
- Prepare signature-ready Form 5500s and associated schedules, if applicable, and assist with compliance with all mandated reporting and posting/notice requirements for health and welfare plans.
E. Other Plan Administration Requirements
- Facilitate meetings between Client and plan provider representatives as requested.
- Manage carrier transitions and implementations as necessary, including the set up of carrier feeds for all carriers who will accept a feed for an employer, which can be dependent on but not limited to Client’s size, Client’s geography, and specific platform used by the chosen carrier.
- Recommend and help develop enhancements and improvements for employee communications regarding the health benefit plans.
- Recommend particular broker-sponsored seminars, benefit events and educational forums and roundtables, as available.
II. Acknowledgement of Benefits Sale.
Client acknowledges that (i) the solicitation and sale by Namely related to the Platform were separate and independent from the solicitation and sale related to the Employee Benefit Services set forth in this Addendum which was performed by a different Namely sales teams with the appropriate licenses as insurance producers, brokers and/or agents, and (ii) it has been informed by Namely that it (a) can obtain the Subscription to the HRIS, Payroll and Benefits Administration modules without signing on for the Employee Benefits Services, and (b) is under no obligation to purchase any insurance product from Namely or any of its affiliates.
III. Fees for the Benefits Administration Module.
Namely may waive the Fees associated with the Benefits Administration module, including the cost of setting up carrier feeds, if the Client receives the Employee Benefits Services described this Addendum by designating Namely or a Namely affiliate as broker of record as the services provided through the Benefits Administration module, including the set-up of carrier feeds, are directly related to the sale or servicing of the insurance products placed by Namely or its affiliate. No other Fees shall be waived. In the event the Client notifies Namely of its decision to rescind the status of Namely, or its affiliate, as broker of record, Namely will be entitled to charge Client for the Benefits Administration module Subscription and for the set-up of any additional carrier feeds at the prevailing rate.